Provider Demographics
NPI:1033255203
Name:MIDDLEBURGH CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MIDDLEBURGH CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:GILLOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-827-3623
Mailing Address - Street 1:PO BOX 606
Mailing Address - Street 2:168 MAIN ST
Mailing Address - City:MIDDLEBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12122-0606
Mailing Address - Country:US
Mailing Address - Phone:518-827-3624
Mailing Address - Fax:518-827-6632
Practice Address - Street 1:168 MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURGH
Practice Address - State:NY
Practice Address - Zip Code:12122-0606
Practice Address - Country:US
Practice Address - Phone:518-827-3624
Practice Address - Fax:518-827-6632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01379955Medicaid